The role of atopy patch tests in the diagnosis of allergy in atopic dermatitis

Abstract

Despite recent advances in determining the value and indication for use of the atopy patch test in atopic dermatitis, more objective studies are needed. The atopy patch test may be useful in understanding the mechanisms of atopic allergy, and in defining the clinical relevance of the airborne allergens in eliciting dermatitis. Regarding food allergy, the atopy patch test still requires standardization. To date, methodology differs in all published papers; even the gold standard, the challenge test itself, is not appropriately standardized, which makes the interpretation of results less reliable.

Predictive Factors of Eczema-Like Eruptions among Patients without Cutaneous Psoriasis Receiving Infliximab: A Cohort Study of 92 Patients

“…The questionnaire used here was based on validated questions in the International Study of Asthma and Allergies in Childhood [10]. In addition, it has also been shown recently that predictive values of skin atopy patch tests and allergen-specific IgE are estimated to be 45 and 64%, respectively, making it difficult to use them for diagnostic purposes [12]. Despite these limitations, this study more closely reproduces the actual and appropriate clinical setting for the care of patients under anti-TNF therapy.…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…A subset of patients with atopic dermatitis show only atopy patch test positivity while specific IgE to the same allergen remains negative. Regarding food allergy, the atopy patch test still requires standardization (1188)(1189)(1190). It may also be difficult to differentiate between irritative and allergic reactions (1191).…”

Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report

“…An elimination diet should not be recommended for a patient solely on the basis of a positive APT response to a food. 108 All the abovementioned tests require specialist knowledge in their performance and interpretation.…”